486 THE TREATMENT OF DISEASES. 



punched all over with a number of little holes, to admit of the evaporation of the 

 perspiration, so as to avoid the troublesome itching which would be caused by its 

 retention. Care should be taken to see that the plaster is smoothly and equally 

 applied. An attack of lumbago, affecting perhaps the whole loins, often leaves 

 behind it one painful spot which may cause distress only when the body is moved in 

 one direction. Remains of a lumbago like this generally resists the usual methods 

 of treatment, the pain being driven from one spot only to re-appear at another. A 

 large belladonna plaster will generally mitigate the complaint, should it fail to 

 remove it altogether. 



Of the internal remedies, iodide of potassium and nitrate of potash (nitre) may 

 prove useful under the conditions and in the doses referred to whilst speaking of 

 chronic rheumatism. The former salt, however, not unfrequently fails to affect 

 lumbago, even when the complaint is distinctly worse at night. 



It has been claimed for actaea racemosa (cimicifuga) that it subdues lumbago 

 more effectually than any other remedy. It is well worth trying in obstinate cases, 

 but it must be admitted that it often fails. The dose is five drops of the tincture 

 every two hours. 



Khus toxicodendron is useful in many cases of chronic lumbago. It is indicated 

 when the pain is worse when the patient is at rest, but is relieved by movement, 

 and also in cases in which on first moving after rest the pains are increased. 



Sulphur in small doses is frequently of much advantage, and it can be 

 administered either in substance or in the form of the sulphur waters of Aix-la- 

 Chapelle, of Aix in Savoy, or Bareges. Arsenic (Pr. 40) is likewise occasionally 

 adopted as a remedy in long-standing obstinate cases. 



B. Crick in tlie Neck. Crick in the neck, stiff neck, or, to use the technical 

 term torticollis, is usually the result of a cold or of exposure of the affected part 

 to a current of cold air. The pain is sometimes in the back of the neck, but more 

 frequently it affects only one side, the patient being in the latter case compelled to 

 hold his head awry in order to relax the muscles. A patient suffering from a 

 stiff neck not uncommonly presents a somewhat comical appearance, and is often 

 made the subject of much ridicule and joking, but for all that the complaint is a 

 very painful one, and is sometimes very intractable to treatment. A stiff neck in 

 children is not uncommonly the cause of a considerable elevation of temperature, 

 the fever lasting three or four days or more. 



"When the pain of acute torticollis is very great it may be necessary to endeavour 

 to obtain relief by the administration of a hypodermic injection of morphia. Local 

 applications, however, not unfrequently prove successful. Hot fomentations are 

 very valuable, as, for example, a piece of spongio-piline wrung out of hot water 

 and applied either alone or sprinkled with laudanum, or belladonna liniment, or a 

 combination of the two. Turpentine often proves useful in these cases. Over a 

 flannel rung out of hot water a little turpentine should be sprinkled and applied 

 till it produces redness, tingling, and smarting. It is well to bear in mind that as 

 the smarting arising from the turpentine goes on augmenting for some time after its 

 removal, the application should be kept on only just sufficiently long to excite a 

 moderate degree of pain 



